Nursing Interventions for Reducing Catheter-Associated Urinary Tract Infections

The article discusses the effectiveness of nursing interventions in reducing catheter-associated urinary tract infections (CAUTI) occurrence. While no single intervention proved more effective, limiting the length of urinary catheters and removing them early were found to be positive outcomes. The significance of this research lies in its potential to inform nursing practice and improve patient care. By conducting further research, nurses can develop evidence-based protocols to reduce CAUTI rates, ultimately safeguarding patients' health and well-being.

Data Analysis: Catheter Associated Urinary Tract Infection
Prevention
Heba ibrahim
Grand Canyon university

Abstract
Catheter related urinary tract contaminations are a widely avoidable growing distress in health
care. To address the PICO query: "Does removing urinary catheters less than 24 hours after
placement reduce to risk of developing catheter associated urinary tract infections (CAUTI‘s)
compared to having urinary catheters in greater than 24 hours in hospitalized patients?" four
nursing research articles were critiqued and anal} zed.
Throughout the four articles reviewed, it was determined that there is no urinary catheter
intervention that proved to be more effective than another. Along with these findings, the data in
the articles discussed that there is a problem with urinary catheter care compliance at the nursing
level. Although the articles did not provide enough adequate information to answer the PICO
question stated above, removing catheters early rather than later showed to have a common
positive outcome in all of the research.
Data Analysis: Catheter Associated Urinary Tract Infection Prevention
In nursing, when there is a clinical issue without a prompt arrangement, inquiry is done to decide
the most ideal approach to tackle this issue (Nieswiadomy, 2008).By seeking for the best
solution to solve this problem, nurses are developing evidence-based nursing practice
(Nieswiadomy. 2008). Evidence-based nursing practice is definite (Nieswiadomy, 2008) as
“nursing practice that is based on the best available evidence, particularly research finding" (p.
401). Nursing choices are assisted by the elucidation of research findings and prove based
research. The reason for this task is to reflect how nursing information is dispersed for use in
individual and expert practice (Singleterry, 2013).
PICO Question
As research assumes an essential part in nursing practice, it is significant to see how research

questions are shaped. One approach for research in nursing is using the PICO format (Riva.
Malik, Burnie. Endicott, & Busse. 2012). The letters in PICO tells about the terms populace,
intercession, correlation, and result, and together they help abridge inquire about research
questions that investigate the response to a clinical issue (Riva et al., 2012). The population in a
PICO question is the subjects that are involved in your exploration question, where the mediation
is the treatment or what is planned to be done to the population to decide its adequacy against the
issue (Riva et al., 2012). Correlation is the control mass that you are looking at the intervention
to that determines if you get the desired outcome that represents and examines the effectiveness
of the intervention (Riva et al., 2012).
The PICO question in this assignment is: Does expelling urinary catheters fewer than 24 hours
after situation lessen to danger of creating catheter related with urinary tract diseases (CAUTI's)
contrasted with taking urinary catheters in more noteworthy than 24 hours in hospitalized
patients? The conspicuous approach to kill CAUTI's is to stay away from the arrangement of
urinary catheters all together. Despite the fact that this would take care of the issue, catheter
utilize assumes a vital part in diagnosing and recuperating. The following best thing is to
diminish the measure of time urinary catheters that are utilized by evacuating them instantly
when they are not required again (Griffiths and Fernandez 2007). By noting the PICO question
expressed above, it could be resolved if it is removed. The urinary catheters under 24 hours after
arrangement will have a positive result for the security of patients. This exploration likewise
empowers nurture by providing them with the data expected to give the best nature of care when
utilizing urinary catheters.
Methodology
The CINAI—IL database was used to acquire articles for inquire about on noting the above
PICO question. The pursuit watchwords utilized were “CAUTI prevention AND nurse, “together
with “urinary catheter AND nurse”. To limit analyzes, the journal subset was changed to nursing,
peer-inspected article box was checked, and the range of the date was changed to 2007-213.
These activities were done to help and guarantee the validity of the articles and rearrange the
consequences of the inquiry. The Cochrane database was utilized to find a fundamental survey of

articles regarding this matter. The catch phrases "catheter AND nurse" were utilized to locate the
accurate article. To assemble data to answer the PICO question, just nursing research
contemplates were utilized as incorporation criteria. These articles were believed to be the most
beneficial because of the expansive part that nursing plays in CAUTI counteractive action. The
articles were determined to be nursing research if the authors were nurses, the article was
published in a nursing journal and/or the subject matter of the article was nursing related.
Discussion of Literature
The literature used in this assignment discussed the safety by taking into consideration CAUTI‘s
in Healthcare by defining the interventions that were appeared to be effective in diminishing the
rate of infection.
Article 1
This nursing research article clearly defines its purpose statement at the end of the literature
review as to develop and implement interventions to decrease the amount of CAUTI incidence
(Oman et al.. 2012). This study was exempt from going through a review board because it was a
hospital quality improvement project. The authors provided a short but concise literature review
that involved an evidence table that abridged their discoveries. A professional/post mediation
configuration was utilized to empower the analysts to decide whether there was a change after
each intervention by comparing the patients before and after the intervention was used. Although
the sample size is not easily defined in the article, the authors state that they used all of the
patients on two isolate units in one clinic who had an indwelling urinary catheter set and
avoided the individuals who had underdone urologic surgery. Data at the ratio level was used to
perform statistical tests to determine the effectiveness of each intervention used to decrease the
rate of CAUTI occurrence. By using a select few trained infection control nurses to collect the
data, the validity, and continuity in the collection of data was preserved. The authors found
thatthrough starting and actualizing healing center wide nursing intercession, the CAUTI rate for
the office will diminish. The arrangements created were worked around the length of remain in
the healing facility, the term the catheter was utilized, and the items used to embed and clean the

catheters. Through training of staff and strict consistence, changing healing facility strategy can
have a positive result for CAUTI aversion.
Article 2
Although one of the authors is not a nurse, this article proves to be nursing research based on the
joumal it was published in along with topic of CAUTI prevention being discussed (Rothfeld &
Stickley. 2010). The article demonstrates to be inadequately written due to the lack of
information it provides regarding being approved by an ethics committee, providing a clear
purpose statement, and indicating the study framework. The reason for this article gives off an
impression to diminish the measure of CAUTI's by decreasing the measure of urinary catheter
utilizes. The authors discuss their literature review appropriately and determined that
constraining catheter utilization and term of catheter situation is a huge piece of CAUTI
avoidance. Interval information was gathered to decide whether diminishing the measure of
catheters utilized would lessen CAUTI event displaying in this information in bar graph format.
Ordinal data was also collected from a survey taken by the nurses to gain their opinions of the
effectiveness of the study. The information was gathered by the attendants dealing with the
patients remaining in the two picked units being seen at the healing center. The small sample size
used by the authors may have had a negative effect on the validity of this study.
Although the think about demonstrated a reduction in CAUTI's from utilizing less urinary
catheters and restricting the span they are utilized, the quantity of diseases per catheter stayed
unaltered (Rothfeld Sr Stickley, 2010). This may propose that the reduction in CAUTI rate
generally is specifically identified with the reduction in measure of urinary catheters utilized.
Even with the limitations in this study and the inadequacy of the article design, the authors
proved that it is possible to limit the measure of urinary catheters utilized as a part of a healing
center focus and that it can positively affect CAUTI rates.

Article 3
Distributed in the Journal of Urologic Nurses, this nursing research article is an efficient survey
of the articles with respect to the length and evacuation of catheters in contrast with CAUTI
event (Bernard, Hunter, & Moore, 2012). The main statement is easily established and visibly
stated in more than one place. The authors reviewed a substantial amount of literature to provide
an adequate background for the topic. Using online databases and specific catchphrases, just nine
articles out of the 53 that were surveyed were utilized as the example. This empowered the
creators to gather the ordinal information they were searching for and show it successfully
through tables, albeit constraining the proof to help their motivation.
The audit of articles done by these writers found that nursing drove intercessions were effective
in reducing CAUTI occurrence (Bernard, Hunter, & Moore, 2012).Although no intervention was
initiated to work well than by some other amid their survey, diminishing the length of urinary
catheter span showed to fall the event of CAUTI's in more than one examination (Bernard,
Hunter, & Moore, 2012). Due to the small sample size of articles reviewed, the authors
determined that it was necessary to have additional indication to regulate the best intervention to
use to reduce the degree of CAUTI‘s in acute-care settings (Bernard, Hunter, & Moore, 2012).
Article 4
This Cochrane analysis the treatment in the research article clearly defines its purpose statement
as to determine the best strategy to remove indwelling urinary catheters, paying close attention to
the number of patients who require re-catheterization after removal (Griffiths & Fernandez,
2007). The literature review provided by the authors displayed a large amount of information in
an appropriate amount of space. Using only random controlled trials that were comparable to
their purpose statement, the authors comprised of 26 different lessons in their review. This test
estimate gives sufficient data to the authors to develop answers related to the purpose of this
study. Since the purpose of this review is to discuss whether or not studies found results from
different interventions referring to the prevention of CAUTI's, the level of measurement of the

data is ordinal.
After reviewing 26 articles, Griffiths and Fernandez (2007) determined when removing catheters
early there are a decrease risk of infection but also an increased risk of voiding difficulties (132).
A decrease in hospital stay was also found to be significant when referring to the length urinary
catheter placement (Griffiths & Fernandez, 2007).
Significance to Nursing
Indwelling urinary catheters are regularly found in the healing center setting with around 15-25%
of all hospitalized patients having a catheter set to screen strict admission and yield or following
a surgery (Griffiths & Fernandez, 2007). Unfortunately, CAUTI‘s are a common concern in the
health care setting (Oman et al.. 2012). In checking the articles above it is evident that there are a
wide range of mediations that can be utilized to diminish the event of CAUTI's. Although there
was not one intervention that seemed to have the most generous effect, constraining the measure
of catheters located was a determined to be an intervention with a positive outcome. Since
catheters cannot be eliminated altogether, another intervention that was found to have a positive
outcome was removing the urinary catheter immediately when no longer needed (Griffiths &
Fernandez. 2007), Using this information, more research can be done to determine the best
intervention to decrease the rate of CAUTI’s in the health care setting. This future research may
change protocols and nursing practice to ensure that nurses are doing all that they can to decrease
and eliminate CAUTI rates in health services. By conducting so the nature of care and wellbeing
of our patients can be safeguarded.

References
Bernard. M. 3. Hunter. K. F.. & Moore. K. N. (2012). A Review of Strategies to Decrease the
Duration of Indwelling Urethral Catheters and Potentially Reduce the Incidence of Catheter-
Associated Urinary Tract Infections. Urologic Nursing,32 (1). 29-37
Griffiths. R.. & Fernandez. R. (2007). Strategies for the removal of short-term indwelling
urethral catheters in adults. (‘ochrone Database (2f'.3:vsiemaric Reviews. (2),
Nieswiadomy. R. M. (2008). Foundations of nursing research. (5th ed). Upper Saddle River,
New Jersey: Pearson Prentice Hall.
Oman. K. S.. Flynn. Fink. R.. Schraeder. N.. Huletl. T.. Keech. T.. & Wald. H. (2012).Nurse-
directed interventions to reduce catheter-associated urinary tract infections,Ameri'conJorrrnoi
()flnfeeiron Control. 40(6). 548-553,
doi:10.1016fj.ajic.2011.07.018
Riva, J. J., Malik. K. P., Burnie, S. J.. Endicott, A. R, & Busse. J. W. (2012). What is your
research question? An introduction to the PICOT format for clinicians,Journal OfThe Canadian
Chiropractic Association, 56(3). 167-171.
Rothfeld. A. & Stiekley. A. (2010). A program to limit urinary catheter use at an acute care
hospital. American Journal ()flnkciron Contra}. 38(7). 568-571. doi: 10. 1016/j.ajic.2009. 12.017

Singleterry. L. (2013). NURS Research in Nursing |Course Syllabus Fall 2013].
Retrieved from httpgfiu\\.fCl'1'iS.cdu/H'I‘MLS/eolleges/alliedhe/does/nursing in l} RS. 350.
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